Adjustable occipital plate

ABSTRACT

An adjustable occipital plate includes a fixation plate, at least one lateral rod configured to be coupled to said fixation plate, at least one laterally sliding link configured to be coupled to and configured to be compressed around said at least one lateral rod to create a friction fit, and at least one rod connector coupled to said at least one laterally sliding link that is configured to receive at least one posterior cervical rod.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application claims priority to U.S. Provisional ApplicationNo. 60/724,962, to Purcell, filed Oct. 7, 2005, and titled “AdjustableOccipital Plate” and incorporates its entire disclosure hereby byreference.

BACKGROUND OF THE INVENTION

Field of the Invention

The present invention relates generally to the field of surgery, andmore specifically, to an adjustable occipital plate which may be used inconjunction with a posterior rod system to fixate the occipital/cervicaljunction between the cranium and the spine.

Background of the Invention

Occipito-cervical fixation has been achieved using a variety oftechniques which generally provide stabilization of the base of theskull with respect to the neck. In order to promote fusion, for example,bone struts formed of autogenous ribs or curved iliac crest struts havebeen fixed to the occiput and spinous processes, cervical laminae, orfacets. Wires are used to fix the struts in place until bone fusionoccurs.

The thickness of the occiput varies, however, and thus, the occiput istypically wired in regions of greater thickness such as near the foramenmagnum, a the nuchal line, and along the midline crest. Holes aredrilled in the occiput to receive the wires that are also fed throughholes in the struts. Although bone fusion occurs with this technique,the struts may be weak prior to fusion, and additional orthosis isapplied such as with a halo vest or other hard collar until the strutscan provide acceptably strung immobilization. Alternatively, metalstruts may be used.

Other techniques for occipito-cervical fixation involve the use of othermetal implants. One metal implant is a stainless steel, U-shaped deviceknown as a Steinman pin. The threaded pin is bent to match the contourof the occipito-cervical region, and fixed to the occiput and cervicallaminae or facets using wires. The pin is generally symmetricallydisposed about the spine, with the sides of the “U” creating a centralregion in which a bone graft can be disposed and further wired to thepin. When attached to the occiput and spine, the pin assumes aninverted-U configuration. Several holes are formed in the occiput sothat the U-bend may be fixed in place.

Additional metal implants include grooved or roughened titanium rods,smooth steel rods in the form of a Hartshill rectangle or Ransford loop,a Cotrel-Dubousset rod screw plate, and titanium frames have beenemployed.

SUMMARY OF THE INVENTION

Embodiments of the present invention are directed to an adjustableoccipital plate for fixating the occipital/cervical junction betweencranium and the spine. Some embodiments of the present invention use avariety of components to achieve a range of motion in several differentaxes. This extended range of motion allows the plate to adapt to thesurrounding anatomy as well as making it more facile to adapt to aposterior rod fixation system.

In one embodiment, an adjustable occipital plate is presented whichincludes a fixation plate, at least one lateral rod configured to becoupled to the fixation plate, at least one sliding link configured tobe coupled to the at least one lateral rod, and at least one posteriorcervical rod configured to be coupled to the at least one sliding linkusing at least one rod connector.

In another embodiment, an adjustable occipital plate is presented whichincludes a fixation plate, two lateral rods configured to be coupled tothe fixation plate, two sliding links, each configured to be coupled toeach of the two lateral rods, and two posterior cervical rods, eachconfigured to be coupled to each of the two sliding links using rod twoconnectors.

In another embodiment, a method of assembling an adjustable occipitalplate is presented which includes providing a fixation plate and atleast one lateral rod, slidably coupling at least one sliding link tothe at least one lateral rod, connecting the fixation plate to the atleast one lateral rod, and coupling at least one posterior cervical rodto the at least one sliding link using at least one rod connector.

In some embodiments, the components of the adjustable occipital platemay be initially variable and free to move, but may also be locked in astatic position once correct placement is achieved in a patient.

The fixation plate may be a bone plate that includes a configuration ofone or more (or a plurality) openings for receiving bone screws. Theplate may also include attachment points for lateral rods. The lateralrods may be attached to the fixation plate and may extend laterally fromthe midpoint of the plate. Accordingly, the rods are used to achieverotation and translation with the corresponding sliding links.

The sliding links may be used as a connector between the lateral rods,rod connector, and cervical rods. Such links may be free to movelaterally and/or rotationally, and may be compressed to lock staticallywith the torque of the setscrew.

The rod connectors may be connected to the sliding links and may be heldin place with a washer. To that end, the rod connectors may receive theposterior cervical rod as well as a setscrew (the setscrews may be theactuating mechanism that locks the entire assembly).

Further embodiments, features, objects and advantages of the invention,as well as structure and operation of various embodiments of theinvention, are disclosed in detail below with references to theaccompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention is described with reference to the accompanyingdrawings. Like reference numbers appearing in the figures indicateidentical or functionally similar elements. Additionally, the left-mostdigit(s) of a reference number identifies the drawing in which thereference number first appears.

FIG. 1 illustrates an exemplary embodiment of an adjustable occipitalplate, according to the present invention.

FIG. 2 illustrates another exemplary embodiment of an adjustableoccipital plate, according to the present invention.

FIG. 3 is a side view of an exemplary sliding link along with rodconnector, according to the present invention.

FIG. 4 is another side view the exemplary sliding link along with rodconnector, according to the present invention.

FIG. 5 is a flowchart, illustrating an exemplary method of assemblingand installing an adjustable occipital plate, according to the presentinvention.

FIG. 6 is an enlarged perspective view of the exemplary adjustableoccipital plate illustrated in FIG. 1.

FIG. 7 is a perspective view of another embodiment of an exemplaryadjustable occipital plate, according to the present invention.

FIG. 8 is an exploded view of the embodiment of the exemplary adjustableoccipital plate illustrated in FIG. 7.

FIG. 9 is an enlarged perspective view of a portion of the exemplaryadjustable occipital plate illustrated in FIG. 7.

FIG. 10 is an enlarged perspective view of a portion of the exemplaryadjustable occipital plate illustrated in FIG. 7 that includes a bonegraft portion.

FIG. 11 is a perspective, cross-sectional view of a bone graft that canbe used with an adjustable occipital plate illustrated in FIG. 7.

FIG. 12 is another perspective, cross-sectional view of the hone graftshown in FIG. 11.

DETAILED DESCRIPTION OF THE INVENTION

As shown in FIGS. 1-4, which illustrate exemplary embodiments of such anadjustable occipital plate according to the present invention,adjustable occipital plate 100 includes a fixation plate 102, a lateralrod 108, a first sliding link 114, a second sliding link 116, a firstrod connector 118, a second rod connector 120, a first posteriorcervical rod 130, and a second posterior cervical rod 132.

According to some embodiments, the lateral rod 108 may include a middleportion 107, a first end 110, and a second end 112, with the middleportion 107 being located between the first end 110 and the second end112. In some embodiments, the fixation plate 102 may also incorporatemiddle portion 107, and the middle portion may also be integral with orcoupled to the two lateral rods 110, 112. In the following description,the terms “first and second ends 110, 112” and “first and second lateralrods 110, 112” are used interchangeably. As can be understood by oneskilled in the art, other embodiments of the lateral rod 108 arepossible.

The angle of the middle portion 107 can be variable, depending on asetting desired for a particular patient. The first end 110 may alsoinclude a stopper 111 configured to prevent sliding link 114 fromsliding away from the lateral rod 108. The second end 112 may alsoinclude a stopper 113 configured to prevent, sliding link 112 fromsliding away from the lateral rod 108. In some embodiments, the fixationplate 102 may be coupled to the middle portion 107 of the lateral rod108. The fixation plate 102 may be coupled to the middle portion 107 ina way so it is symmetrically placed with respect to the two ends 110 and112. In an embodiment, the fixation plate 102 can glued, welded,screwed, or attached by any other means to the lateral rod 108 (or thelateral rods 110, 112). In an alternate embodiment, the fixation plate102 and the lateral rod 108 can be an integral structure. In yet anotheralternate embodiment, the fixation plate 102 and the ends 110, 112 canbe separate structures that are coupled together to form a fixationplate 102 and lateral rod 108 structure as shown in FIG. 1. As can beunderstood by one skilled in the art, other embodiments of the fixationplate 102 and the lateral rod 108 are also possible.

The first sliding link 114 may be configured to be secured to the firstend 110 of the lateral rod 108. As shown in FIG. 4, the first slidinglink 114 includes a top portion 412 and a bottom portion 414, coupled toeach other by a round portion 410. In one embodiment, each of theportions 410, 412, 414 has a substantially uniform thickness. As can beunderstood by one skilled in the art, the thicknesses can be variable.

The top and bottom portions 412, 414 are preferably substantiallyparallel and adjacent to each other, as shown in FIG. 4. The roundportion 410 may include a hollow interior 416 configured to accommodatethe first end 110 (not shown in FIG. 4). The top and bottom portions412, 414 can be pushed closer together using the setscrew 126 located inthe rod connector 118. Once the portions 412, 414 are pushed together,the round portion 410 compresses, thus, decreasing the diameter of thehollow interior 416. Once the round portion 410 is compressed, itcreates a friction fit coupling with the first end 110 (not shown inFIG. 4). The frictional it prevents the first sliding link fromtranslation and rotation movements about the first end 110. To preventfurther slippage and provide additional support, a washer 122 may beplaced between the rod connector 118 and the top portion 412 of thefirst sliding link 114.

The rod connector 118 may also include a tunnel opening 418 that extendssubstantially parallel to the top and bottom portions 412, 414. Thetunnel opening 418 is configured to accommodate insertion of the firstposterior cervical rod 130 (not shown in FIG. 4). In one embodiment, thetunnel opening 418 can extend through the first rod connector 118 andsetscrew 126. In this way, upon the first posterior cervical rod 130being inserted through the tunnel opening 418, both ends of rod 130 canextend beyond the rod connector 118, as shown in FIGS. 1 and 2.

FIG. 3 is another side view of the rod connector 118, illustrating anopening 310 located on an exterior surface of the rod connector 118. Theopening 310 serves to accommodate insertion of the posterior cervicalrod 130. Once the rod 130 is inserted into the opening 310, it is pushedthrough the tunnel opening 418 not shown in FIG. 3). Once pushed throughthe tunnel opening 418, the rod 130 protrudes through an opening in therod connector 118, similar to the opening 310, located on the exteriorof the rod connector 118 and opposite to the opening 310 (as shown inFIGS. 1 and 2). FIG. 3 further illustrates top and bottom portions 312and 314 of the sliding link 114, which are similar to portions 412 and414 (FIG. 4), respectively. The cervical rod 130 may be secured to thesliding link 114 by tightening the setscrew 126. In one embodiment, thesetscrew 126 may also be statically secure sliding link 114 to the firstend 110.

The first rod connector 108 may be configured to rotate about an axisthat is substantially perpendicular to the top portion 412, as shown inFIG. 2. By rotating the first rod connector 108, a position and anorientation of the first posterior cervical rod 130 can be adjusted.This enables a surgeon to custom fit the adjustable occipital plate 100to a particular patient. The setscrew 126 may statically secure the rodconnector 108 to the sliding link 114.

The first sliding link 114 may be configured to rotate about the firstend 110, as shown in FIG. 2. In an alternate embodiment, the firstsliding link 114 may be configured to translate along the first end 110,as is also shown in FIG. 2. The first sliding link 114 may be translatedbetween stopper 111 and the point where the fixation plate 102 couplesto the first end 110. This type of translation may be referred to asmedial lateral translation.

The above-referenced translations and rotations allow a surgeon tocustom-fit the occipital plate to a patient in accordance with patient'sphysiological characteristics and needs.

Referring back to FIG. 1, the fixation plate 102 includes two openings104 a and 104 b, configured to acconunodate screws 106 a and 106 b,respectively. Screws 106 can be cervical screws or any other type ofbone screws or attachment/fastening means/devices. As can be understoodby one skilled in the art, the fixation plate 102 may include at leastone opening 104, where each opening 104 accommodates a screw 106. Thefixation plate 102, along with the screw(s) 106, allows attachment ofthe occipital plate 100 to bone in the neck region of the patient.

As shown in FIGS. 1 and 2, the posterior cervical rod 130 includes a rodconnector attachment section 142, a curved section 144, and an elongatedsection 146. The rod connector attachment section 142 is configured tobe inserted into the rod connector 118. The curved section 144 has acurvature that can be selected based on specific patient's physiologicalcharacteristics (though the curved section may be replaced by an angledsection). The curved section 144 couples to the connector attachmentsection 142. The elongated section 146 couples to the curved section 144and is configured to be inserted into patient's cranium region. Theelongated section 146 may have a variable length that can be selectedbased on specific patient's physiological characteristics. As can beunderstood by one skilled in the art, similar situations exist withregard to the second posterior cervical rod 132.

As can also be understood by one skilled in the art, the abovedescription with regard to the first sliding link 114 is equallyapplicable to the second sliding link 116.

FIG. 6 is an enlarged perspective view of a portion of the adjustableoccipital plate 100 illustrated in FIGS. 1-4. As illustrated, the plate100 includes the fixation plate 102, rods 110, 112, sliding links 114,116, rod connectors 118, 120, setscrews 126, 128, and cervical rods 130,132. As discussed above with respect to FIGS. 1-4, the adjustableoccipital plate 100 is configured to secure at least one cervical rod130 (or 132) and thereby connect portions of the patient's neck andcranium.

Another embodiment of an adjustable occipital plate is illustrated inFIGS. 7-10. As shown, an adjustable occipital plate 700 includes afixation plate 702, lateral rods 710, 712, a first sliding link 714, asecond sliding link 716, a first rod connector 718, a second rodconnector 740, a first posterior cervical rod 730, and a secondposterior cervical rod 732. The fixation plate 702 includes a middleportion 707 to which the first lateral rod 710 and the second lateralrod 712 are coupled. When the plate 700 is assembled, the middle portion707 is located between the first lateral rod 710 and the second lateralrod 712. FIG. 10 illustrates the adjustable occipital plate incombination with a bone graft.

The fixation plate 702 can be integral to rods 710, 712 (e.g., unitarystructure) or may be attached to the rods by means of welding, gluing,soldering, a locking mechanism, and the like. The angle of the middleportion 707 can be variable, depending on a setting desired for aparticular patient. The first rod 710 may also include a stopper 711that is configured to prevent sliding link 714 from sliding away fromthe rod 710. The second rod 712 may also include a stopper 713 that isconfigured to prevent sliding link 716 from sliding away from the rod712. The fixation plate 702 can be placed symmetrically with respect tothe two rods 710 and 712.

The first sliding link 714 may be configured to be secured to the firstrod 710 in a fashion similar to one shown in FIG. 4. As shown in FIG. 8,the first sliding link 714 includes a top portion 747 and a bottomportion 745. The top and bottom portions 747, 745 are substantiallyparallel to each other and may be attached to each other using a curvedportion 748. The curved portion 748 has a diameter that is substantiallyequal to or slightly greater (or, in some cases, smaller) than thediameter of the first rod 710, prior to threading and tighteningsetscrews 726 and 728. This way, the curved portion 748 can be placedover the first rod 710 and thereby allows translational and rotationalmovement of the sliding link 714 (as discussed in FIGS. 1-4) along thefirst rod 710 when the sliding link 714 is not secured to first rod 710.

The top and bottom portions 747, 745 further include openings 753, 751,respectively. The openings 753 and 751 may configured to allow placementof the first rod connector 718. The openings 753, 751 may be circular,though, as can be understood by one skilled in the art, these openingscan have any other shape.

The first rod connector 718 includes a top portion 761 and a baseportion 762, with the base portion 762 having a greater diameter thanthe top portion 761. The top portion and the base portion may becircular, though, as can be understood by one skilled in the art, theseportions can have any other shape. The top portion 761 further includesa channel 764 configured to have a width that is substantially equal toor slightly greater than the diameter of the posterior cervical rod 730.In this way, the cervical rod 730 can be accommodated by the first rodconnector 718. The channel 764 is preferably configured to have a depththat is substantially equal to or slightly greater than a combination ofthe height of the setscrew 726 and the diameter of the cervical rod 730.This allows the setscrew 726 to secure the cervical rod 730, when thecervical rod 730 is placed in the channel 764.

The channel 764 may be further configured to have a threading 741 on itsinner walls. The setscrew 726 is configured to have a threading 743. Thethreading 741 and threading 743 are configured to interact with eachother, when the setscrew 726 is inserted into the channel 764 to securethe cervical rod 730.

To secure the cervical rod 730, the top portion 761 of the rod connector718 is first inserted through the opening 751 of the bottom portion 745of the first sliding link 714 and then the top portion 761 is insertedthrough the opening 753 of the top potion 747 of the sliding link 714.The top portion 761 is inserted until the base portion 762 contacts thebottom portion 745 of the sliding link 714. Once this occurs, the baseportion 762 prevents any further movement through the openings 751, 753.FIG. 9 is a perspective view of a portion of the adjustable occipitalplate 700 that illustrates rod connectors 718, 720 placed through theopenings 751 and 753 of the sliding links 714, 716.

The cervical rod 730 may then be placed inside the channel 764 and thesetscrew 726 threaded along threads 741 of the channel 764 to secure thecervical rod 730. By advancing the setscrew 726 along the threads 741,the top and bottom portions 747, 745 are forced together (i.e., the baseportion 762 and the cervical rod 730 are brought together). Once theportions 747, 745 are forced together, the curved portion 748 of thesliding link 714 securely grips the lateral rod 708 and fixes (orfriction fits) the sliding link 714 to the lateral rod 708.

As can be understood by one skilled in the art, the above description ofthe first sliding link 714, the first rod connector 718, the firstsetscrew 726, and the first posterior cervical rod 730 is alsoapplicable to the second sliding link 716, the second rod connector 720,the second setscrew 728, and the second posterior cervical rod 732. FIG.7 illustrates the adjustable occipital plate 700 with the rods 730, 732being secured to the sliding links 714, 716, respectively. As can befurther understood by one skilled in the art, there can be any number ofposterior cervical rods secured to the adjustable occipital plate 700.

Prior to securing the cervical rod 730, a surgeon (or any otherqualified user) may adjust the position and orientation of the slidinglink 714 as well as the position and orientation of the cervical rod730. As discussed above with regard to FIG. 2, the sliding links 714,716 are preferably configured to rotate about lateral rods 710, 712,respectively, as well as (preferably), translate along the lateral rods710, 712, respectively. The posterior cervical rods 730, 732 may also beconfigured to rotate about an axis that is substantially perpendicularto the top surface of the sliding links 714, 716. The cervical rods 730,732 may also be configured to translate along channel 764 of the rodconnectors 718, 720, respectively. The above-referenced translations androtations allow a surgeon to custom-fit the occipital plate to a patientin accordance with patient's physiological characteristics and needs.

Referring back to FIG. 7, the fixation plate 702 includes three openings704 (a, b, c). The openings 704 (a, b, c) are configured to accommodatecervical screws or any other type of screws or attachment/fasteningdevices (see FIG. 1). As can be understood by one skilled in the art,the fixation plate 702 may include at least one opening 704, where eachopening 704 accommodates a screw. The fixation plate 702 along with thescrew(s) allows attachment of the occipital plate 700 to bone in theneck region of the patient.

The structure of the posterior cervical rods 730, 732 may be similar tothe structure of the cervical rods 130, 132 of FIGS. 1-2 discussedabove.

An embodiment of an exemplary method 500 that may be used to assembleand adjust the occipital plate 100, shown in FIGS. 1-4, as well as,install it for the purposes of connecting patient's cranium and spine isillustrated in FIG. 5. As can be understood by one skilled in the art,the method 500 is equally applicable to the adjustable occipital plate700 discussed above with regard to FIGS. 7-10.

Accordingly, in step 502, the surgeon (or any other qualifiedprofessional) examines the patient to determine patient's physicalcharacteristics. Based on those characteristics, as illustrated in step506, the surgeon selects a fixation plate 102 having a length, width,and thickness and including at least one opening 104 for insertion of atleast one screw 106. The surgeon may then select a first end 110, asecond end 112 and couple them to the selected fixation plate 102.Alternatively, the surgeon may select a lateral rod 108 and couple therod to the fixation plate 102.

The first and second sliding links 114, 116 may be configured to beslidably coupled to the first and second ends 110, 112, respectively,prior to the ends being coupled to the fixation plate 102, as shown instep 504.

Steps 508-514 illustrate adjustment of the occipital plate 100 and ascan be understood by one skilled in the art, can be performed in anyorder. Referring to steps 508-514, once the ends with the sliding linksare coupled to the fixation plate 102, the surgeon may adjust theposition of the sliding links by translating them along the respectiveends. The surgeon may also adjust the links' angle of orientation byrotating them around the ends.

The surgeon may then insert the posterior cervical rods 130 and 132 intothe respective rod connectors on the sliding links 114, 116. The rods130, 132 may be inserted into the rod connectors prior to attachment ofthe sliding links to the ends 110, 112. Alternatively, the rods 130, 132may be inserted into the rod connectors prior to adjustment of thesliding links. As can be understood by one skilled in the art, theinsertion of rods 130, 132 (one or both) may be done at any time.

The rods 130, 132 may be then also rotated around axes that aresubstantially perpendicular to the surface of the respective slidinglinks. Once, the rods are set to a specific position, the rods may besecured to the sliding links using respective setscrews 126, 128. In anembodiment, the setscrews 126, 128 may be tightened using a tighteningtool (such as a wrench, a screwdriver, allen-wrench, and the like). Thetightening also secures the sliding links 114, 116 to the respectiveends 110, 112.

As can be understood by one skilled in the art, the adjustment of thesliding links (including the cervical rods) may be performed when thefixation plate 102 is coupled to the patient's spine. Thus, a surgeoncan install the occipital plate 100 into the patient' spine and thenrotate and translate various components of the plate 100 and, afterthat, lock them into a static configuration. Thus, prior toinstallation, the occipital plate 100 may have a variety of motionsabout its various axes, but once it is installed, it may be secured in astatic non-moving positions. Alternatively, the occipital plate 100 maybe adjusted outside of the patient's body, then locked into a staticconfiguration, as illustrated in step 516. In another alternateembodiment, the occipital plate 100 may be partially secured, theninstalled into the patient, and locked into a static configuration.

As can be understood by one skilled in the art, other possible ways ofadjusting and installing the occipital plate 100 are possible. Further,a static configuration of the occipital plate 100 is a configurationthat may allow fewer motions (e.g., translations and rotations of atleast one component of the plate 100) than its dynamic configuration,i.e., when none of the components are secured.

Referring back to FIG. 7, the adjustable occipital plate 700 isillustrated with the bone graft 1001 that is attached to the middleportion 707. The middle portion 707 may include a contoured extension orprotrusion 1003 having a contoured edge 1004, In one embodiment, thecontoured extension 1003 may be referred to as a graft containmentmechanism, which may be configured to better secure the bone graft 1001to the adjustable occipital plate 1001. The bone graft 1001 may be usedto promote fusion at the occipito-cervical junction by creating a bridgebetween the occiput and the cervical lamina.

The bone graft 1001 is further illustrated in FIGS. 11-12. In anembodiment, the bone graft 1001 may be multi-contoured having variousshapes and edges to further promote fusion at the occipito-cervicaljunction. As illustrated, the bone graft 1001 is further configured toinclude a C2 lamina contour 1102 (shown as lamina contour 1206 in FIG.12), a plate contact area 1202 (shown in FIG. 12), and a occiput contactarea 1204 (shown in FIG. 12). The lamina contour 1102 (or 1206) orgraft's distal end may be pre-contoured to adapt to posterior elementsof the cervical spine (e.g., lamina, facets, spinous process). The platecontact area 1202 and the occiput contact area 1204 are pre-contoured toadapt to the adjustable occipital plate 700 and the occiput,respectively. In an embodiment, the bone graft 1001 may be manufacturedfrom any biocompatible material, such as polyetheretherketone (PEEK),allograft tissue, titanium, and the like. As can be understood by oneskilled in the art, the bone graft 1001 may have any shape, size,length, width, thickness, height, structure, or any other parameters.

Example embodiments of the methods and components of the presentinvention have been described herein. As noted elsewhere, these exampleembodiments have been described for illustrative purposes only, and arenot limiting. Other embodiments are possible and are covered by theinvention. Such embodiments will be apparent to persons skilled in therelevant art(s) based on the teachings contained herein. Thus, thebreadth and scope of the present invention should not be limited by anyof the above-described exemplary embodiments, but should be defined onlyin accordance with the following claims and their equivalents.

The invention claimed is:
 1. An adjustable occipital plate assembly,comprising: a fixation plate, the fixation plate including a pair ofopenings at a first end, and a protrusion at a second end that extendsaway at an angle from a second plane formed by the pair of openings andis configured to contain a bone graft; a lateral rod coupled with thefixation plate, wherein the lateral rod is coupled to the second end andextends transverse to a length of the fixation plate from the first endto the second end and in a third plane substantially parallel to thesecond plane; a pair of links configured to rotate and translate aboutthe lateral rod; a pair of rod connectors coupled with the pair oflinks; and a pair of set screws.
 2. The adjustable occipital plateassembly of claim 1, wherein each of the pair of links is configured torotate in a first plane normal to a longitudinal axis of the lateral rodand translate along the longitudinal axis of the lateral rod.
 3. Theadjustable occipital plate assembly of claim 1, further comprising apair of screws configured to engage the pair of openings to attach thefixation plate to a cranium.
 4. The adjustable occipital plate assemblyof claim 1, wherein each of the pair of the lateral links furthercomprises: a link top portion with a top opening, a link bottom portion;a round portion coupling the top portion and bottom portion that wrapsaround a portion of the lateral rod; a connector base portion coupledwith the link bottom portion; a connector top portion extending throughthe top opening and having a threading; and a channel configured toreceive a cervical fixation rod, wherein each of the pair of rodconnectors is configured to rotate in a fourth plane normal to an axisof the top opening.
 5. The adjustable occipital plate assembly of claim4, further comprising a bottom opening in the link bottom portionconfigured to receive the connector top portion through the bottomopening.
 6. The adjustable occipital plate assembly of claim 4, whereineach of the pair of set screws is configured to engage a respectivethreading to secure a respective cervical fixation rod within arespective channel.
 7. The adjustable occipital plate assembly of claim6, wherein each of the pair of set screws is configured to compress thelink top portion and link bottom portion to create a friction fitbetween the round portion and the lateral rod.
 8. An adjustableoccipital plate, comprising: a fixation plate; at least one lateral rodconfigured to be coupled to said fixation plate; at least one laterallysliding link configured to be coupled to and configured to be compressedaround said at least one lateral rod to create a friction fit, whereinthe at least one laterally sliding link includes a round portion with anadjustable diameter; and at least one rod connector coupled to said atleast one laterally sliding link that is configured to receive at leastone posterior cervical rod.
 9. The adjustable occipital plate of claim8, wherein at least one laterally sliding link is configured totranslate along the at least one lateral rod in a medial lateraldirection.
 10. The adjustable occipital plate of claim 8, wherein the atleast one laterally sliding link is configured to rotate about the atleast one lateral rod in a plane normal to the at least one lateral rod.11. The adjustable occipital plate of claim 8, wherein the at least onerod connector is configured to rotate relative to the at least onelaterally sliding link.
 12. The adjustable occipital plate of claim 8,further comprising at least one set screw configured to engage the atleast one rod connector to compress the at least one cervical rod andthe at least one laterally sliding link to create the friction fit. 13.The adjustable occipital plate of claim 8, wherein the at least one rodconnector extends through a top portion of the at least one laterallysliding link to receive the at least one posterior cervical rod.
 14. Theadjustable occipital plate of claim 8, in combination with at least oneposterior cervical rod coupled with the at least one rod connector. 15.The adjustable occipital plate of claim 8, further comprising a graftcontainment mechanism configured to secure a bone graft to the fixationplate.
 16. An adjustable occipital plate assembly, comprising: afixation plate including first end with a pair of openings and a secondend with a protrusion that extends away at an angle from a first planeformed by the pair of openings and that includes a contoured extensionconfigured to contain a bone graft between the cranium and a cervicalvertebra; a pair of screws configured to engage the pair of openings toattach the fixation plate to a cranium; a lateral rod coupled with thesecond end and extending transverse to the fixation plate in a secondplane substantially parallel to the first plane; a pair of linksconfigured to rotate and translate about the lateral rod, each linkincluding a link top portion with a top opening, a link bottom portion,and a round portion coupling the top portion and bottom portion thatwraps around a portion of the lateral rod; a pair of rod connectorscoupled with the pair of links, each rod connector including a connectorbase portion coupled with the bottom portion, a connector top portionextending through the top opening and having a threading, and a channelconfigured to receive a cervical fixation rod; and a pair of set screws,each set screw configured to engage the threading of a respective rodconnector to secure a respective cervical fixation rod.